Brain hemorrhage in elderly adults

Brain hemorrhage in the elderly

Cerebral hemorrhage is a type of stroke in elderly adults. Brain hemorrhage may occur in adults due to the rupture of a blood vessel in the brain, causing blood to gather inside the head.

Internal bleeding in the brain leads to increased head pressure, which causes a lack of blood and oxygen supply to the brain. This may result in the loss of nerve cells in the brain and cause severe, irreversible symptoms. Therefore, brain bleeding in adults must be given particular importance and treated as soon as possible.

Cerebral hemorrhage may happen for several reasons; the cause may be due to an accident or a severe blow to the skull that led to the explosion of a blood vessel in the brain, and the causes of brain hemorrhage in older adults may be due to the presence of diseases and risk factors that contributed to the rupture of a cerebral artery without the person being exposed to any traumatic injury Read more about the causes and symptoms of brain hemorrhage in adults and how to treat it appropriately.

What are the symptoms of brain hemorrhage in elderly adults?

Some people fear that there may be internal bleeding in their brain without realizing it, and that is why knowing the symptoms of cerebral hemorrhage may be helpful , detect it early before the situation develops to cause serious complications threatening the patient’s life.

There are many signs and symptoms of brain bleeding, as the symptoms differ from one patient to another according to the location of the bleeding, its severity, and the injury to which the person was exposedAphasia).

Despite the many symptoms of a cerebral hemorrhage in adults and their diversity, in most cases, at least one of these symptoms will appear:

  • Sudden, severe headache
  • Partial or complete paralysis in the movement of one of the two sides of the body (right or left).
  • Vomiting and nausea
  • Vision changes (blurring or decreased vision and possibly blindness)
  • dizziness, confusion
  • Difficulty swallowing food
  • Poor balance (cerebellar hemorrhage)
  • Aphasia
  • Difficulty reading or writing
  • Poor sense of taste
  • Irregular heartbeat and breathing problems (bleeding in the brainstem)
  • Changes in consciousness (a tendency to be drowsy and coma may occur)
  • Epileptic seizures

What was previously mentioned is one of the most common symptoms that patients with cerebral hemorrhage may suffer from. The patient doesn't need to suffer from all these symptoms; just one sign that appeared suddenly is enough to indicate the possibility of bleeding inside the brain.

Image showing the most common symptoms of brain hemorrhage in adults
Symptoms of cerebral hemorrhage in adults

Causes of cerebral hemorrhage in elderly adults

Many causes and risk factors may lead to cerebral hemorrhage, and these causes are as follows:

Injuries on the skull

A violent blow to the head or a fall on the skull may result in an explosion in a blood vessel in the head and a life-threatening cerebral hemorrhage.

Trauma to the skull does not necessarily cause bleeding in the brain. It is possible for blood vessels around the brain (the meninges) to burst, causing massive bleeding around the brain. Read more about Internal bleeding in the head.

Trauma is responsible for most cases of cerebral hemorrhage in children and adults under 50. Cerebral hemorrhage in the elderly is often attributed to other diseases due to the lack of motor activities that may cause injuries.

High blood pressure

When the blood pressure rises without controlling it with the necessary medications, a blood vessel in the brain may burst on its own due to the excessive force applied to the walls of the blood vessels.

High blood pressure has become one of the most common diseases. It is very important to follow the doctor's antihypertensive medications to prevent sudden brain bleeding in adults. You can read more about Causes of high blood pressure in women.

Brain aneurysm

Aneurysm is a balloon-like bulge in the wall of an artery. This bulge may burst at any moment, causing severe bleeding in the brain.

Many people have aneurysms without knowing that, as they are usually not accompanied by any signs until they burst and cause internal bleeding, and they are often formed due to high blood pressure; you can read more about Endovascular coiling used in the treatment of aneurysm.

ischemic stroke

A blood clot formed in one of the brain vessels or moved from another place to a blood vessel in the brain may cause damage to the wall of this vessel, which leads to blood leakage and cerebral hemorrhage in adults.

Stroke is usually classified into ischemic (clot) and hemorrhagic (bleeding in the brain) strokes, but sometimes a clot can cause bleeding in the brain in adults. Read more about brain stroke.

Disorders of blood clotting

Coagulation disorders (blood clotting) are responsible for causing some cases of brain hemorrhage. The same applies to anticoagulant drugs, as these drugs increase the possibility of brain hemorrhage in the elderly.

Some people suffer from diseases that make blood clotting more complicated than others. When minor bleeding occurs in healthy people, the human body stops this bleeding through blood coagulation. In contrast, in patients with coagulation diseases, the clotting does not succeed, and therefore this superficial bleeding can turn to severe bleeding.

This type of disease increases the risk of brain bleeding in adults, including sickle cell anemia and hemophilia.

Brain tumors

Benign or malignant tumors in the brain may press on the surrounding cerebral tissues and structures, including the blood arteries, leading to the rupture and bursting of one of these vessels. Read more about Brain tumors.

A picture of the most important causes of a cerebral hemorrhage in adults, such as uncontrolled high blood pressure and aneurysms
Causes of cerebral hemorrhage in elderly adults

Diagnosis of cerebral hemorrhage in elderly adults

Establishing a diagnosis quickly is very important to avoid severe complications of a cerebral hemorrhage. After the doctor has asked about the symptoms and how the signs appeared (gradually or suddenly), he performs a physical and neurological examination and then orders one of these tests:

CT scan

CT scan of the head is one of the most important tests used in the detection and diagnosis of Brain hemorrhage in adults, it is possible through this test to determine the presence of a cerebral hemorrhage with its exact location. Still, it may fail to detect the cerebral hemorrhage in its early stages, as MRI can detect it more quickly.

CT image that shows cerebral hemorrhage in adults
Cerebral hemorrhage on a CT image

Cerebral angiography

This test can locate brain bleeding by injecting a contrast medium and taking an X-ray image of the brain vessels, as this image can show cerebral vascular abnormalities.

How to treat a brain hemorrhage in elderly adults

After diagnosing cerebral hemorrhage and determining its location using imaging methods or approaching the patient's symptoms, the medical team begins to define the appropriate treatment steps for the case. Every cerebral hemorrhage is considered an emergency case that must be transferred to the hospital quickly.

Doctors may perform emergency surgery to relieve head pressure if a compressive hematoma forms around the brain. This surgery is done by making a small hole in the skull and pulling out the hematoma through the hole. In cases of severe bleeding, head and skull surgery may be the best option.

It is possible to resort to modern treatments to relieve pressure inside the head in some cases of brain hemorrhage in the elderly, such as using the endoscopic third ventriculostomy technique. which is performed by making a small hole in the brain's third ventricle to allow cerebrospinal fluid drainage and relieve cranial pressure.

After controlling brain bleeding in the elderly, then the patient’s risk factors can be addressed to prevent, as much as possible, another bleeding in the brain, and among these measures are the following:

  • Adjust blood pressure if it is high
  • Undergo cerebral vascular anomaly ablation (AVM) surgery
  • Management of an unruptured cerebral aneurysm by Vascular coiling surgery Which aims to prevent an increase of aneurysm size and reduce the chances of its explosion
  • A naso-oral feeding tube is placed, or an intravenous line
  • Painkillers to reduce the severity of pain

In conclusion, brain hemorrhage in adults may have dangerous consequences for the patient's life when neglecting to provide treatment as soon as possible. Cerebral hemorrhage in the elderly manifests with many sudden symptoms and signs, such as severe headaches, blurred vision, difficulty speaking, and weakness or muscle paralysis. Emergency treatment of brain hemorrhage is required in all cases of bleeding. You should not delay consulting your doctor when you notice any symptoms or signs of bleeding.


  1. Webmd
  2. Medical News Today
  3. NIH

Frequently Asked Questions

Many cerebral hemorrhages may heal on their own without causing severe complications in the long run, especially in cases of mild or transient cerebral hemorrhage. However, this matter cannot always be relied upon. The injured person must be taken to the hospital immediately for fear of severe consequences of the bleeding that threatens the patient’s life.

Sudden death may occur when the blood compresses essential brain centers, such as those responsible for breathing or regulating the heartbeat in the brain stem.

It is impossible to predict how long it takes for a person in a coma due to a brain hemorrhage to wake up; it can take hours or days and even weeks or months in severe brain injuries.

Brain bleeding may lead to partial or complete paralysis in one or both sides of the patient's body. Muscular paralysis may affect only the right half of the patient's body. Paralysis may be limited to the left half of the body. In rare cases, it may include both sides, depending on the location and severity of bleeding in the brain.

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